Lasers have been used extensively to perform surgery, especially on the eye. The surgical devices utilizing laser power are basically divided into two types, non-contact and contact.
In the non-contact type, laser light transmission systems typically use a flexible quartz fiber in combination with a neodymium: YAG laser or an argon laser, or a mirror reflection system in combination with a carbon dioxide laser. Since these light transmission systems are non-contact systems, they have distinct disadvantages including inaccurate beam orientation, damage to the quartz tip should it come into contact with tissue or blood, and the lack of the surgeon's typical "touch technique".
Of the contact type of laser-powered surgical devices, one comprises an artifical sapphire probe connected to a quartz fiber for use with an Nd:YAG laser. In this device, the tip of the sapphire probe engages the tissue to be treated. The treatment comprises photocoagulation, cutting, or tissue vaporization, which is also known as ablation. In this device, the sapphire probe is coupled via a connector to the end of the quartz fiber which in turn is connected to the laser.
While the sapphire probe contact system is advantageous in providing accuracy and a touch technique, it does have significant disadvantages. First, tissue tends to adhere to the sapphire probe, thereby tending to damage adjacent tissue structures when the probe is moved. Secondly, the sapphire probe tends to provide too much coagulation of the tissue due to heat, thereby scarring and opacifying, for example, ocular tissue.
Accordingly, there is still a strong and continuing need for improvement in constructing laser-powered devices for surgery.